Анемия и венозные тромбоэмболические осложнения – состояния неспецифические для какой-либо одной нозологии. Сегодня для коррекции анемии широко применяются эритропоэз-стимулирующие препараты. Однако повышение гемоглобина/гематокрита неоднозначно позитивно, поскольку потенциально способно усиливать склонность к тромбообразованию в венозном русле. При различных заболеваниях и состояниях эта тенденция выражена по-разному. Мнения о эритропоэз-стимулирующих препаратах как о реальных факторах риска развития венозных тромбоэмболических осложнений также различаются. Тем не менее адекватным результатом действия эритропоэз-стимулирующих препаратов является только баланс между их антигипоксическим эффектом (выгода) и отсутствием развития венозных тромбоэмболических осложнений (риски). Дополнительно для адекватного назначения эритропоэз-стимулирующих препаратов следует оценивать соотношение «затраты/эффект».
Anaemia and venous thromboembolism (VTE) are nonspecific conditions for any one nosology. For day erythropoiesis-stimulating agents (ESA) are widely applied to anaemia therapy. However hemoglobin/hematocrit increase is ambiguously positive because it promotes potentially the blood clot formation in veins. Such tendency is expressed differently for various diseases and disorders. The specialists looks differs too ESA is real risk factor for VTE development. Nevertheless both antihypoxic effect and VTE absence are to one required effect of ESA as good benefit/risk ratio. In additional, good ESA administration should take into account the «cost/effectiveness» ratio too.
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Авторы
Е.В.Ройтман
ФГУ Федеральный научно-клинический центр детской гематологии, онкологии и иммунологии Минздравсоцразвития РФ, Москва
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E.V.Roitman
Federal Research and Clinical Center on Children’s Hematology, Oncology and Immunology, Health Ministry of Russian Federation, Moscow